Not a Real Doctor
This piece was written in August, 2023 - six months into my first year as a Junior Medical Officer (JMO) working within New South Wales Health. It breaks my heart to re-read these words. At the time, I was exhausted, isolated and unsure of both myself and my career. The feelings that I express regarding work are not normal nor acceptable, however, are unfortunately very uncommon amongst many JMOs and trainees within the public health system. Help is always available. If you or someone you know is struggling with their mental health, please contact Lifeline.
I am twenty-five years old. I have spent a quarter of my time on earth - the entirety of my adult life - studying for a career that I now despise.
I am a doctor.
But not a real doctor,demanding of society’s respect and admiration and gratitude. I am a junior doctor, a JMO (junior medical officer). In university, a surgeon once told my class, “you will soon be below the level of shit that cakes the operating room floor…” Fortunately for his ego, he was right. Here I am now, below the shit.
I am the person in the hospital that patients hope to avoid. I appear only to cannulate, educate or devastate.
I am spoken to only when others want something from me: pain relief, laxatives, permission to smoke. Or a gentle, listening ear that will graciously absorb all of a patient’s hatred and disgust for a public healthcare system that treats their individual health ailments for free, and to which I am a servant.
No matter how hard I work, I am always behind. This is usually the result of me having to extinguish fires that I did not light, find solutions to problems that are no particular person’s fault, but somehow mine to solve.
The hospital is short of eight beds, and needs fourteen discharges to make room for the new admissions before midday?
Call the JMO.
A patient is complaining of an itchy backside?
Call the JMO.
The family of a gentleman who passed away overnight would like to know how to access his body because Aunty Jenny couldn’t make it to the bedside before he died?
Call the JMO.
Generally, I am no more qualified to solve any of these issues than the person on the other end of my deck phone. However, it is presumed that the additional few years I spent at university somehow correlate to me being the holder of all knowledge, including information that has nothing to do with medicine itself. I am expected to a capable clinical, efficient administrator, patient advocate and confident leader in an environment that would push any other person to the brink of insanity just by trying to excel at one of these roles. I am expected to be always available, always proactive, and always able to accomodate the priorities of others at any given moment, whilst simultaneously ploughing through a bottomless to-do-list of my own.
~
Despite being at work for upwards of ten hours a day, I am always short for time. If it not short for time at work, it is time do to things in “real life,” the things that actually make living somewhat tolerable. I give everything that I am proud of to this job - my knowledge, my communication skills, my tenacity - and yet most days, I walk out of the Emergency Department taunted by the feeling that my best was not good enough. There is always more work that can be done. And if not more, then the work could always be better. Such headlines litter Facebook feeds each and every day.
The public healthcare system fails again…
Doctor makes yet another fatal mistake…
Empathy: out the window…
What these claims fail to recognise is that behind the sliding doors of Australia’s public healthcare system are thousands of individuals, many not dissimilar to myself, who turn up to their job each day knowing that for the next twelve hours, the only certainty is that the day will be pure chaos. In our comfortable, mostly controllable, modern world, unknown is seen to be synonymous with exciting. Let me tell you: it’s not. The unknown is terrifying.
In what other profession does someone sit in their car before work, sobbing with fear, not only for people dying, but for having to face a day where they know that they will be stretched beyond their physical and emotional capacity? In what other profession does a person wake up nauseous with exhaustion after having to work eight hours of overtime, because their colleagues are off sick and there are not enough staff employed to fill empty shifts? In what other profession would it be acceptable for an employee to have to pronounce a person dead and then return to their desk to discharge two other patients home without even five minutes to process the meaning of life?
~
The expectations placed on JMOs are beyond what is humanly possible. At the end of the day, most of us are just young people trying to make a start in a new career. However, in this job, a mistake is not just a mistake; a mistake can cost a life. It is career that is not conducive with being a well individual. Like many of my colleagues, I am tired and traumatised. I feel worn out by the relentlessness of every day. I also feel that perhaps the healthcare system is failing patients because it is failing those who work for it.
~
I think about quitting my job more days than I do not. However, what enables me to show up to work day after day is the hope that one day I might be able to make a difference in changing our healthcare system for the better, be it through improving the experience of a single patient or advocating for the rights of my colleagues. Right now, I feel that the former is impossible. Therefore, I speak for my fellow workers when I argue that providing better care for patients must begin with reckoning the expectations placed on junior doctors. From a more clearly defined role, it may be possible to implement greater supports, be it emotionally, physically or financially. In the absence of such change, Australia’s medical system is at risk of loosing individuals who have potential to make lasting, sustainable change to patient’s experience of healthcare before they have even had a chance to flourish.
